CPR Hands Placement: How to Position your Hands During Chest Compressions

A cardiac arrest victim doesn't receive oxygen to the brain and other vital organs during the arrest. This is often fatal if appropriate steps are not taken immediately. During these life-threatening emergencies, CPR or Cardiopulmonary Resuscitation can make a difference between life and death by squeezing the heart and pushing oxygenated rich blood throughout the victim's body. 

High-quality compressions are the most critical part of Cardiopulmonary Resuscitation. And it begins with positioning your hands correctly. It's vital to always practice the correct hand placement when doing CPR.

Key Takeaway

High-quality CPR is vital for survival after cardiac arrest, and quality chest compressions are critical to the performance of CPR. The 2015 guidelines and recommendations of the American Heart Association and Emergency Cardiovascular Care on hand placement for chest compressions seem understandable by both laypersons and healthcare professionals.

  • Several components, such as hand position, the position of the victim, and the position of the rescuer, can alter the quality of external chest compressions.
  • A constant non-dominant hand position may unintentionally decrease the quality of CPR for those rescuers.
  • For adults and older children, hand placement is in the center of the chest between the nipples
  • For infants or children younger than 1-year-old, position 2 fingers in the center of the chest just below the nipple line.
  • Hands-only CPR refers to uninterrupted compressions without rescue breaths.
  • In the American Heart Association recommendation, rescue breathing is more important for infants and younger children.

The Importance of Quality Chest Compressions

Chest compression is the most important component of CPR. If someone is in cardiac arrest, their heart is either not beating or cannot circulate blood to the brain and other vital organs. Abdominal compressions squeeze the victim's heart to manually pump the heart and circulate oxygenated blood to the body. 

If compressions are not performed adequately, blood circulation may not be effective. If compressions are ineffective, CPR will be ineffective too. On the other hand, effective chest compressions can keep a person viable until help arrives and can even get the heart beating again on its own.

Does Hand Placement Affect the Quality of Chest Compressions?

Hand placement has a significant effect on the quality of chest compressions. Correct hand placement and effective chest compression during Cardiopulmonary Resuscitation are essential for several reasons, each vital to the safety and survival of the cardiac arrest victim. To give a high-quality CPR, the rescuer must follow the American Heart Association standard and current guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular in out of the hospital settings. In addition, an up-down hand position switch may delay the fatigue of non-dominant hand position rescuers. It also improves chest compression quality during Cardiopulmonary Resuscitation.

The effects of dominant and non-dominant hand positions on Emergency Cardiovascular Care quality have also been investigated for professional healthcare providers and lay rescuers based on the CPR guidelines. For example, if the non-dominant hand position of a single rescuer switches the up-down hand position during CPR, the proportion of non-dominant hand-position-CPR will decrease; thus, the rescuer's fatigue will decrease, and the chest compression quality will increase.

How many hands should I use during CPR?

You can use either one or two of your hands during CPR. However, more pressure is applied to the chest when using two arms. Therefore, using both hands is recommended when performing CPR on adults and children above 8 years old. Adult bones are typically not as fragile as infants, so using two hands will help you achieve the deeper compressions you need.

For young children, generally between 1 and 8 years old, using one hand is recommended. As for infants, you must only use two or three of your fingers to perform CPR because they are more fragile than pre-teens and teenagers. Too much pressure can end up breaking their bones or causing organ damage.

What should be CPR Hands Placement for Adults?

You can use either one or two of your hands during CPR. However, more pressure is applied to the chest when using two arms. Therefore, using both hands is recommended when performing CPR on adults and children above 8 years old. Adult bones are typically not as fragile as infants, so using two hands will help you achieve the deeper compressions you need.

For young children, generally between 1 and 8 years old, using one hand is recommended. As for infants, you must only use two or three of your fingers to perform CPR because they are more fragile than pre-teens and teenagers. Too much pressure can end up breaking their bones or causing organ damage.

What is the Best Hand Placement for Children and Infant?

You can use either one or two of your hands during CPR. However, more pressure is applied to the chest when using two arms. Therefore, using both hands is recommended when performing CPR on adults and children above 8 years old. Adult bones are typically not as fragile as infants, so using two hands will help you achieve the deeper compressions you need.

For young children, generally between 1 and 8 years old, using one hand is recommended. As for infants, you must only use two or three of your fingers to perform CPR because they are more fragile than pre-teens and teenagers. Too much pressure can end up breaking their bones or causing organ damage.

What is Hands-Only CPR?

Hands-Only CPR can be just as effective as conventional CPR. Hands-only CPR refers to uninterrupted chest compressions without rescue breaths. The purpose of hands-only CPR is just the same as conventional CPR - to get the blood pumping through the victim's body until the emergency medical team arrives on the scene and performs more advanced life support.